EDN1和CFH的基因多态性与2型糖尿病增生性视网膜病变的相关性

Association of EDN1 and CFH gene polymorphisms with proliferative diabetic retinopathy in type 2 diabetes mellitus

目的:探讨基因多态性与2型糖尿病(type 2 diabetes mellitus,T2DM)患者发生增生性糖尿病性视网膜病变(proliferative diabetic retinopathy,PDR)的相关性。方法:2019年1月至2020年9月桂林医学院附属医院收治的700名T2DM患者,分为无糖尿病性视网膜病变(non-diabetic retinopathy,NDR)组(n=386)与PDR组(n=314)。收集临床基本资料,抽取患者外周血,使用竞争性等位基因特异性聚合酶链反应(kompetitive allele specific polymerase chain reaction,KASP)基因分型检测法检测两组患者血清中的内皮素-1(endothelin 1,EDN1)基因的rs5370位点和补体因子H(complement factor H,CFH)基因的rs800292位点基因型。用logistic回归分析这2个基因位点的多态性与广西汉族T2DM患PDR的关系。结果:收缩压、使用胰岛素治疗以及肾小球滤过率(glomerular filtration rate,GFR)的分析结果显示两组间差异有统计学意义(P_(收缩压)=0.025,P_(胰岛素)=0.001,P_(GFR)=0.013)。排除以上混杂因素后,EDN1基因的rs5370位点上TT基因型与PDR易感性呈正相关(P=0.03,OR=2.973;adj.P=0.011,OR=2.718);CFH基因的rs800292位点上AA基因型与PDR易感性呈正相关(P=0.037,OR=1.949;adj.P=0.044,OR=2.058)。结论:收缩压增高、GFR降低可能与T2DM患者发生PDR相关。EDN1基因的rs5370位点与CFH基因的rs800292位点的多态性与广西汉族人群的PDR易感性显著相关。

Objective:To investigate the relationship between gene-polymorphisms and proliferative diabetic retinopathy in patients who have type 2 diabetes mellitus(T2 DM).Method:A total of 700 hospitalized T2 DM patients were included in this study from January 2019 to September 2020.They were divided into two groups:the nodiabetic retinopathy(NDR)group(n=386)and the proliferative diabetic retinopathy(PDR)group(n=314).Basic clinical data were collected,and clinical indexes affecting diabetic retinopathy were analyzed.Two tag SNPs rs5370 in endothelin 1(EDN1)and rs800292 in complement factor H(CFH)were examined using kompetitive allele-specific polymerase chain reaction(KASP)genotyping assays.Logistic regression was used to analyse the relationship between the polymorphisms of these two SNPs and PDR in a Guangxi Han population with T2 DM.Results:Significant differences were found through the analysis of the systolic blood pressure-whether using insulin or not-and the glomerular filtration rate(GFR)between the two groups(P;=0.025,P;=0.001,P;=0.013)The TT genotype of rs5370 was determined to be associated with an increased risk of PDR(P=0.03,OR=2.973;adj.P=0.011,OR=2.718).The AA genotype of rs800292 was also determined to be associated with an increased risk of PDR(P=0.037,OR=1.949;adj.P=0.044,OR=2.058).Conclusion:Increased systolic blood pressure and decreased GFR may be associated with PDR in patients with T2 DM.The rs5370 polymorphism of the EDN1 gene and the rs800292 polymorphism of the CFH gene are significantly associated with the risk of PDR in Guangxi’s Han population.